Neonatologists receive advanced, specialized training in caring for critically or acutely ill newborns. Working in hospital neonatal intensive care units, or NICUs, they care for infants with serious illnesses, birth defects, injuries and also the typical problems of premature infants. In addition to college, medical school and a pediatrics residency, they study at least three more years in critical newborn medicine. Neonatologists are well prepared for the medical aspects of their work, but the emotions and stresses of playing such a vital role in a newborn's health and life are hazards to be considered before deciding on the career.

Critical Decision-Making

Neonatologists work with critically ill newborns and premature babies whose very lives may depend on the decisions the physician makes. (Reference 1) While it can be rewarding to know you've played a key role in a newborn's life, (Reference 2) it can also be an overwhelming responsibility. Newborns are so small -- and many times even smaller in the NICU -- that their conditions can change very quickly. Making accurate diagnoses and ordering the right tests is critical to the job. Every decision the neonatologist makes is important, and that in itself can be a very stressful work environment.

Family Involvement

Educating an anxious family about their newborn's serious condition is an important and sometimes difficult part of the job. (Reference 2) Although sometimes the baby's condition is diagnosed before it's born, many times the situation is unexpected. Neonatologists must be able to convey the diagnosis clearly to the parents accurately yet in layman's terms so that it's understood. The parents may have decisions to make regarding the baby's care, so their understanding is critical. Neonatologists need to display equal parts professionalism and compassion.

Exhausting Schedules

Neonatologists typically work in hospital NICU departments in shifts that are long and tiring. They spend most of their work day standing, caring for their tiny patients and coordinating their care with other physicians and nurses. Their schedules are also unpredictable; they can expect to be called in for emergencies or to stay beyond their shift when the intensive care nurseries are busy. Although physicians like neonatologists know this is the nature of their job from the outset, working under such schedules day after day can take its toll. Neonatologists must therefore take special care of themselves, getting adequate rest and good nutrition, to stay healthy for the job.

Daily Drama

No day is the same as another in neonatology. As with any specialty with an emergency nature, the unpredictable challenges are part of what draw people to the field. But the daily drama a neonatologist faces -- with alarms ringing to signal a baby in distress, an emotional family in the wings, and critical newborns arriving daily -- is an environment a physician can't prepare for in advance. Interns experience the hazards of the job in training, but it's only when you're the one in charge, making the decisions, and training others that you experience the full drama of the job.